Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2003
Computed tomography scanning of the sciatic nerve posterior to the femur: Practical implications for the lateral midfemoral block.
Using computed tomography (CT) scans of the thighs, this study addresses sciatic nerve anatomy at the injection site for the lateral midfemoral sciatic nerve block. It addresses the recommendation of neutral leg rotation to facilitate block placement. ⋯ The characteristics of sciatic nerve anatomy described in this study support observations and clinical recommendations regarding lateral midfemoral sciatic nerve block.
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Reg Anesth Pain Med · Sep 2003
Comparative Study Clinical TrialComparison of heart rate response to an epinephrine test dose and painful stimulus in children during sevoflurane anesthesia: heart rate variability and beat-to-beat analysis.
During regional anesthesia, various stimuli leading to an adrenergic response can occur. However, simulation of an epidural test dose by using intravenous administration of epinephrine (EPI) has always been compared with an intravenous saline infusion as the control. The aim of this study was to evaluate the possibility of distinguishing in children the effect on HR by an intravascular epinephrine infusion and a painful stimulus, using heart rate variability (HRV) and beat-to-beat analysis of HR. ⋯ Detection of the secondary HR decrease, 60 seconds after the first change in HR, allows us to distinguish the effects of a painful stimulus from those related to the epinephrine test dose at 1 MAC of sevoflurane. This secondary HR decrease induced by epinephrine appears primarily because of a compensatory increase in parasympathetic tone.
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Reg Anesth Pain Med · Sep 2003
Clinical TrialLateral approach to the sciatic nerve block in the popliteal fossa: correlation between evoked motor response and sensory block.
The purpose of this study was to identify which of two motor responses of the foot (plantar flexion versus dorsiflexion) best predicts complete sensory blockade of the sciatic nerve when is used for lateral popliteal sciatic nerve block. ⋯ After stimulation of the sciatic nerve, plantar flexion better predicts complete sensory blockade of the foot than dorsiflexion when using the lateral approach to the popliteal fossa. The findings of the present study apply to a single injection of 30 mL of ropivacaine 0.75%.